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Cranial electrotherapy stimulation alleviates depression-like behavior of post-stroke depression rats by upregulating GPX4-mediated BDNF expression. Behav Brain Res 2023; 437:114117. [PMID: 36116735 DOI: 10.1016/j.bbr.2022.114117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022]
Abstract
To elucidate whether cranial electrotherapy stimulation (CES) improves depression-like behavior of post-stroke depression (PSD) via regulation of glutathione peroxidase 4 (GPX4)-mediated brain-derived neurotrophic factor (BDNF) expression. Middle cerebral artery occlusion (MCAO) and chronic unpredictable mild stress (CUMS) were used to develop a rat PSD model. CES was applied, and RAS-selective lethal 3 (RSL3) was injected into the hippocampus to inhibit GPX4 in PSD rats. The depression behavior was detected by sucrose preference and forced swimming tests. The structure and morphology of the hippocampus were observed and analyzed by histopathological hematoxylin-eosin (HE) staining. The mRNA and protein expressions of GPX4 and BDNF in the hippocampus were detected by qRT-PCR, western blot and immunohistochemical analysis.The degeneration and necrosis of hippocampal neurons, the depression-like behavior were severer and the expression of BDNF in the hippocampus were decreased in PSD rats than those in MCAO and control groups. CES promoted the hippocampal neuron repair, alleviated the depression-like behavior and increased the expression of BDNF in PSD rats. The inhibition of GPX4 by RSL3 exacerbated the depression-like behavior and decreased the expression of BDNF in PSD rats. In addition, we found that RSL3 disrupted the positive effects of CES on the PSD rats. Conclusion: CES improves depression-like behavior of PSD rats through upregulation of GPX4-mediated BDNF expression in the hippocampus.
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Johnson MI, Paley CA, Wittkopf PG, Mulvey MR, Jones G. Characterising the Features of 381 Clinical Studies Evaluating Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief: A Secondary Analysis of the Meta-TENS Study to Improve Future Research. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060803. [PMID: 35744066 PMCID: PMC9230499 DOI: 10.3390/medicina58060803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/29/2022]
Abstract
Background and Objectives: Characterising the features of methodologies, clinical attributes and intervention protocols, of studies is valuable to advise directions for research and practice. This article reports the findings of a secondary analysis of the features from studies screened as part of a large systematic review of TENS (the meta-TENS study). Materials and Methods: A descriptive analysis was performed on information associated with methodology, sample populations and intervention protocols from 381 randomised controlled trials (24,532 participants) evaluating TENS delivered at a strong comfortable intensity at the painful site in adults with pain, irrespective of diagnosis. Results: Studies were conducted in 43 countries commonly using parallel group design (n = 334) and one comparator group (n = 231). Mean ± standard deviation (SD) study sample size (64.05 ± 58.29 participants) and TENS group size (27.67 ± 21.90 participants) were small, with only 13 of 381 studies having 100 participants or more in the TENS group. Most TENS interventions were ‘high frequency’ (>10 pps, n = 276) and using 100 Hz (109/353 reports that stated a pulse frequency value). Of 476 comparator groups, 54.2% were active treatments (i.e., analgesic medication(s), exercise, manual therapies and electrophysical agents). Of 202 placebo comparator groups, 155 used a TENS device that did not deliver currents. At least 216 of 383 study groups were able to access other treatments whilst receiving TENS. Only 136 out of 381 reports included a statement about adverse events. Conclusions: Clinical studies on TENS are dominated by small parallel group evaluations of high frequency TENS that are often contaminated by concurrent treatment(s). Study reports tended focus on physiological and clinical implications rather than the veracity of methodology and findings. Previously published criteria for designing and reporting TENS studies were neglected and this should be corrected in future research using insights gleaned from this analysis.
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Affiliation(s)
- Mark I. Johnson
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
- Correspondence: ; Tel.: +44-113-812-30-83
| | - Carole A. Paley
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
- Research & Development Department, Airedale NHS Foundation Trust, Steeton, Keighley BD20 6TD, UK
| | - Priscilla G. Wittkopf
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Matthew R. Mulvey
- Academic Unit of Primary and Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK;
| | - Gareth Jones
- Centre for Pain Research, School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
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Brunyé TT, Patterson JE, Wooten T, Hussey EK. A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples. Front Hum Neurosci 2021; 15:625321. [PMID: 33597854 PMCID: PMC7882621 DOI: 10.3389/fnhum.2021.625321] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/07/2021] [Indexed: 01/27/2023] Open
Abstract
Cranial electrotherapy stimulation (CES) is a neuromodulation tool used for treating several clinical disorders, including insomnia, anxiety, and depression. More recently, a limited number of studies have examined CES for altering affect, physiology, and behavior in healthy, non-clinical samples. The physiological, neurochemical, and metabolic mechanisms underlying CES effects are currently unknown. Computational modeling suggests that electrical current administered with CES at the earlobes can reach cortical and subcortical regions at very low intensities associated with subthreshold neuromodulatory effects, and studies using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) show some effects on alpha band EEG activity, and modulation of the default mode network during CES administration. One theory suggests that CES modulates brain stem (e.g., medulla), limbic (e.g., thalamus, amygdala), and cortical (e.g., prefrontal cortex) regions and increases relative parasympathetic to sympathetic drive in the autonomic nervous system. There is no direct evidence supporting this theory, but one of its assumptions is that CES may induce its effects by stimulating afferent projections of the vagus nerve, which provides parasympathetic signals to the cardiorespiratory and digestive systems. In our critical review of studies using CES in clinical and non-clinical populations, we found severe methodological concerns, including potential conflicts of interest, risk of methodological and analytic biases, issues with sham credibility, lack of blinding, and a severe heterogeneity of CES parameters selected and employed across scientists, laboratories, institutions, and studies. These limitations make it difficult to derive consistent or compelling insights from the extant literature, tempering enthusiasm for CES and its potential to alter nervous system activity or behavior in meaningful or reliable ways. The lack of compelling evidence also motivates well-designed and relatively high-powered experiments to assess how CES might modulate the physiological, affective, and cognitive responses to stress. Establishing reliable empirical links between CES administration and human performance is critical for supporting its prospective use during occupational training, operations, or recovery, ensuring reliability and robustness of effects, characterizing if, when, and in whom such effects might arise, and ensuring that any benefits of CES outweigh the risks of adverse events.
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Affiliation(s)
- Tad T. Brunyé
- U. S. Army Combat Capabilities Development Command Soldier Center, Cognitive Science Team, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Joseph E. Patterson
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Thomas Wooten
- Department of Psychology, Tufts University, Medford, MA, United States
| | - Erika K. Hussey
- U. S. Army Combat Capabilities Development Command Soldier Center, Cognitive Science Team, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
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Stilling JM, Monchi O, Amoozegar F, Debert CT. Transcranial Magnetic and Direct Current Stimulation (TMS/tDCS) for the Treatment of Headache: A Systematic Review. Headache 2019; 59:339-357. [DOI: 10.1111/head.13479] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Joan M. Stilling
- Clinical Neurosciences University of Calgary Calgary AB, Canada
- Cumming School of Medicine University of Calgary Calgary AB, Canada
- Hotchkiss Brain Institute Calgary AB, Canada
| | - Oury Monchi
- Clinical Neurosciences University of Calgary Calgary AB, Canada
- Cumming School of Medicine University of Calgary Calgary AB, Canada
- Hotchkiss Brain Institute Calgary AB, Canada
| | - Farnaz Amoozegar
- Clinical Neurosciences University of Calgary Calgary AB, Canada
- Cumming School of Medicine University of Calgary Calgary AB, Canada
- Hotchkiss Brain Institute Calgary AB, Canada
| | - Chantel T. Debert
- Clinical Neurosciences University of Calgary Calgary AB, Canada
- Cumming School of Medicine University of Calgary Calgary AB, Canada
- Hotchkiss Brain Institute Calgary AB, Canada
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Brønfort G, Haas M, Evans RL, Goldsmith CH, Assendelft WJJ, Bouter LM. WITHDRAWN: Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2014; 2014:CD001878. [PMID: 25157618 PMCID: PMC6483320 DOI: 10.1002/14651858.cd001878.pub3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This review is out of date, but is correct at the date of publication. The review has been withdrawn from The Cochrane Library, but readers can still access previous versions in the 'Other versions' tab. The original author team is preparing three new protocols which will serve to update and replace this review: Manual treatment and spinal rehabilitative exercise for the prevention of migraine attacks in adults, Manual treatment and spinal rehabilitative exercise for the prevention of TTH in adults, and Manual treatment and spinal rehabilitative exercise for the prevention of cervicogenic headaches in adults. For further information, please contact the PaPaS CRG (details here ). July 2017 At July 2017, the series of three new reviews intended to replace this review were withdrawn as they were not able to be completed within the available editorial resource. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Gert Brønfort
- University of MinnesotaIntegrative Health & Wellbeing Research Program, Center for Spirituality & Healing420 Delaware Street SE, MMC505MinneapolisMNUSA55455
| | | | - Roni L Evans
- University of MinnesotaIntegrative Health & Wellbeing Research Program, Center for Spirituality & Healing420 Delaware Street SE, MMC505MinneapolisMNUSA55455
| | - Charles H Goldsmith
- Simon Fraser UniversityFaculty of Health SciencesBlossom Hall, Room 95108888 University DriveBurnabyBCCanadaV5A 1S6
| | - Willem JJ Assendelft
- Radboud University Nijmegen Medical CenterDepartment of Primary and Community Care, 117 ELGPO Box 9101route 117NijmegenNetherlands6500 HB
| | - Lex M Bouter
- VU UniversityDe Boelelaan 1105AmsterdamNetherlands1081 HV
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Waite RL, Oscar-Berman M, RBraverman E, Barh D, Blum K. Quantitative Electroencephalography Analysis (qEEG) of Neuro-Electro-Adaptive Therapy 12™ [NEAT12] Up-Regulates Cortical Potentials in an Alcoholic during Protracted Abstinence: Putative Anti-Craving Implications. ACTA ACUST UNITED AC 2014; 5:1-7. [PMID: 25927012 PMCID: PMC4410813 DOI: 10.4172/2155-6105.1000171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Cranial electrotherapy stimulation (CES) is a noninvasive therapy that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. The effectiveness of CES has been questioned by many and its use is considered controversial. In this study we are presenting data on one alcoholic patient using a newly engineered device we call Neuro-Electro-Adaptive Therapy 12™ [NEAT12]. This hybrid device utilizes TENS current characteristics yielding CES effects. This device has been found to primarily target the excitation of the Cingulate Gyrus region of the brain. CASE PRESENTATION This is a 42 year old male who has been abstinent from alcohol for approximately two months. The data presented herein represents the pre to post qEEG differences of an alcoholic in protracted abstinence. This subject was evaluated both before and after using the NEAT-12 device. The pre to post comparisons suggest that the cortical potentials especially at the Cingulate Gyrus are up regulated after using the device. The absolute power changes obtained shows a decrease of more than 2 SD as noted in the delta wave spectrum. Also noted is an overall cortical increase in the alpha spectrum. The resting alert state of a neuro typical population is most prominently marked by a regulation of 7.5-11 Hz alpha throughout the cortex. The decreased in delta and theta suggests an up regulation of the prefrontal cortex and the anterior Cingulate Gyrus a site involved in substance use disorder (SUD). CONCLUSION A presence of dominant slow waves through the prefrontal cortex and the anterior Cingulate Gyrus is often associated with OCD, anxiety, impulsivity and cravings in addicted populations. It is conceivable that our initial finding of altered electrical activity of the brain using qEEG analysis suggests the NEAT-12 may induce a "normalization" of aberrant electrical activity of the cortical region of the brain known to occur during protracted abstinence of alcoholics. It may have utility as a putative anti-craving CES device and therefore warrants intensive investigation.
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Affiliation(s)
- Roger L Waite
- Department of Nutrigenomic Research, Bio-Clarity, LLC, San Diego, California USA
| | - Marlene Oscar-Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | - Eric RBraverman
- Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, USA ; Path Foundation NY, New York, New York, USA
| | - Debmalya Barh
- Center for Genomics and Applied Gene Therapy, Institute of Integrative Omics and Applied Biotechnology (IIOAB),Nonakuri, Purba Medinipur, West Bengal, India
| | - Kenneth Blum
- Department of Nutrigenomic Research, Bio-Clarity, LLC, San Diego, California USA ; Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, USA ; Center for Genomics and Applied Gene Therapy, Institute of Integrative Omics and Applied Biotechnology (IIOAB),Nonakuri, Purba Medinipur, West Bengal, India ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA ; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA ; Path Foundation NY, New York, New York, USA
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Hanten WP, Olson SL, Hodson JL, Imler VL, Knab VM, Magee JL. The Effectiveness of CV-4 and Resting Position Techniques on Subjects with Tension-Type Headaches. J Man Manip Ther 2013. [DOI: 10.1179/106698199790811816] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lance Whorton R, Kegerreis S. The Use of Manual Therapy and Exercise in the Treatment of Chronic Cervicogenic Headaches: A Series of Case Studies. J Man Manip Ther 2013. [DOI: 10.1179/jmt.2000.8.4.193] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34:274-89. [PMID: 21640251 DOI: 10.1016/j.jmpt.2011.04.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 03/10/2011] [Accepted: 04/03/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this manuscript is to provide evidence-informed practice recommendations for the chiropractic treatment of headache in adults. METHODS Systematic literature searches of controlled clinical trials published through August 2009 relevant to chiropractic practice were conducted using the databases MEDLINE; EMBASE; Allied and Complementary Medicine; the Cumulative Index to Nursing and Allied Health Literature; Manual, Alternative, and Natural Therapy Index System; Alt HealthWatch; Index to Chiropractic Literature; and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, limited, or conflicting) and to formulate practice recommendations. RESULTS Twenty-one articles met inclusion criteria and were used to develop recommendations. Evidence did not exceed a moderate level. For migraine, spinal manipulation and multimodal multidisciplinary interventions including massage are recommended for management of patients with episodic or chronic migraine. For tension-type headache, spinal manipulation cannot be recommended for the management of episodic tension-type headache. A recommendation cannot be made for or against the use of spinal manipulation for patients with chronic tension-type headache. Low-load craniocervical mobilization may be beneficial for longer term management of patients with episodic or chronic tension-type headaches. For cervicogenic headache, spinal manipulation is recommended. Joint mobilization or deep neck flexor exercises may improve symptoms. There is no consistently additive benefit of combining joint mobilization and deep neck flexor exercises for patients with cervicogenic headache. Adverse events were not addressed in most clinical trials; and if they were, there were none or they were minor. CONCLUSIONS Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.
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Affiliation(s)
- Roland Bryans
- Guidelines Development Committee Chair and Chiropractor, Private Practice, Clarenville, Newfoundland and Labrador, Canada.
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Jenkins B, Tepper SJ. Neurostimulation for Primary Headache Disorders, Part 1: Pathophysiology and Anatomy, History of Neuromodulation in Headache Treatment, and Review of Peripheral Neuromodulation in Primary Headaches. Headache 2011; 51:1254-66. [DOI: 10.1111/j.1526-4610.2011.01966.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Jenkins B, Tepper SJ. Neurostimulation for Primary Headache Disorders: Part 2, Review of Central Neurostimulators for Primary Headache, Overall Therapeutic Efficacy, Safety, Cost, Patient Selection, and Future Research in Headache Neuromodulation. Headache 2011; 51:1408-18. [DOI: 10.1111/j.1526-4610.2011.01967.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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ELECTROPHYSICAL AGENTS - Contraindications And Precautions: An Evidence-Based Approach To Clinical Decision Making In Physical Therapy. Physiother Can 2011; 62:1-80. [PMID: 21886384 PMCID: PMC3031347 DOI: 10.3138/ptc.62.5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Rintala DH, Tan G, Willson P, Bryant MS, Lai ECH. Feasibility of using cranial electrotherapy stimulation for pain in persons with Parkinson's disease. PARKINSONS DISEASE 2010; 2010:569154. [PMID: 20976091 PMCID: PMC2957248 DOI: 10.4061/2010/569154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 01/11/2010] [Accepted: 02/28/2010] [Indexed: 11/20/2022]
Abstract
Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy stimulation (CES). Design. Randomized, controlled, double-blind trial. Setting. Veterans Affairs Medical Center, Community. Participants. Nineteen persons with PD and pain in the lower back and/or lower extremities. Thirteen provided daily pain rating data. Intervention. Of the thirteen participants who provided daily pain data, 6 were randomly provided with active CES devices and 7 with sham devices to use at home 40 minutes per day for six weeks. They recorded their pain ratings on a 0-to-10 scale immediately before and after each session. Main Outcome Measure. Average daily change in pain intensity. Results. Persons receiving active CES had, on average, a 1.14-point decrease in pain compared with a 0.23-point decrease for those receiving sham CES (Wilcoxon Z = −2.20, P = .028).
Conclusion. Use of CES at home by persons with PD is feasible and may be somewhat helpful in decreasing pain. A larger study is needed to determine the characteristics of persons who may experience meaningful pain reduction with CES. Guidelines for future studies are provided.
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Affiliation(s)
- Diana H Rintala
- Research Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
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Edelmuth RCL, Nitsche MA, Battistella L, Fregni F. Why do some promising brain-stimulation devices fail the next steps of clinical development? Expert Rev Med Devices 2010; 7:67-97. [PMID: 20021241 DOI: 10.1586/erd.09.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Interest in techniques of noninvasive brain stimulation (NIBS) has been growing exponentially in the last decade. Recent studies have shown that some of these techniques induce significant neurophysiological and clinical effects. Although recent results are promising, there are several techniques that have been abandoned despite positive initial results. In this study, we performed a systematic review to identify NIBS methods with promising preliminary clinical results that were not fully developed and adopted into clinical practice, and discuss its clinical, research and device characteristics. We identified five devices (transmeatal cochlear laser stimulation, transcranial micropolarization, transcranial electrostimulation, cranial electric stimulation and stimulation with weak electromagnetic fields) and compared them with two established NIBS devices (transcranial magnetic stimulation and transcranial direct current stimulation) and with well-known drugs used in neuropsychiatry (pramipexole and escitalopram) in order to understand the reasons why they failed to reach clinical practice and further steps of research development. Finally, we also discuss novel NIBS devices that have recently showed promising results: brain ultrasound and transcranial high-frequency random noise stimulation. Our results show that some of the reasons for the failure of NIBS devices with promising clinical findings are the difficulty to disseminate results, lack of controlled studies, duration of research development, mixed results and lack of standardization.
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Affiliation(s)
- Rodrigo C L Edelmuth
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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Rogers DRB, Ei S, Rogers KR, Cross CL. Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound. Complement Ther Clin Pract 2006; 13:95-101. [PMID: 17400144 DOI: 10.1016/j.ctcp.2006.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 10/09/2006] [Accepted: 10/09/2006] [Indexed: 11/22/2022]
Abstract
This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions.
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Blum K, Chen TJH, Martinez-Pons M, Dinubile NA, Waite RL, Schoolfield J, Blum SH, Mengucci J, Downs BW, Meshkin B. The H-Wave small muscle fiber stimulator, a nonpharmacologic alternative for the treatment of chronic soft-tissue injury and neuropathic pain: an extended population observational study. Adv Ther 2006; 23:739-49. [PMID: 17142209 DOI: 10.1007/bf02850314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In a previous study, the H-Wave small-muscle fiber stimulator significantly reduced chronic pain and restored physical function among patients with pain in the lower and upper extremities and spine. In this extended population observational study, a cross-sectional,computer-administered 10-item survey was administered to 6774 patients (3367 men [49.7%], 3406 women [50.3%], and 1 sex not reported [<1%]; mean+/-SD age, 45.28+/-10.08 y; range, 18-65 y) with chronic soft-tissue injury or neuropathic pain to assess their therapeutic response. The mean+/-SE duration of self-administered H-Wave treatment before the survey was completed was 87.35+/-1.39 d. Sixty-five percent of study participants reported a reduced or eliminated need for pain medication; 79% reported improved functional capacity or activity; and 78% reported 25% or greater reduction of pain. This cross-sectional evaluation represents the largest outcome study on the benefits of the H-Wave device in patients with chronic soft-tissue injury or neuropathic pain. The results suggest that this nonpharmacologic approach may provide an important alternative to standard pharmacologic treatment.
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Affiliation(s)
- Kenneth Blum
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA
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Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelft WJJ, Bouter LM. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004:CD001878. [PMID: 15266458 DOI: 10.1002/14651858.cd001878.pub2] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Non-invasive physical treatments are often used to treat common types of chronic/recurrent headache. OBJECTIVES To quantify and compare the magnitude of short- and long-term effects of non-invasive physical treatments for chronic/recurrent headaches. SEARCH STRATEGY We searched the following databases from their inception to November 2002: MEDLINE, EMBASE, BIOSIS, CINAHL, Science Citation Index, Dissertation Abstracts, CENTRAL, and the Specialised Register of the Cochrane Pain, Palliative Care and Supportive Care review group. Selected complementary medicine reference systems were searched as well. We also performed citation tracking and hand searching of potentially relevant journals. SELECTION CRITERIA We included randomized and quasi-randomized controlled trials comparing non-invasive physical treatments for chronic/recurrent headaches to any type of control. DATA COLLECTION AND ANALYSIS Two independent reviewers abstracted trial information and scored trials for methodological quality. Outcomes data were standardized into percentage point and effect size scores wherever possible. The strength of the evidence of effectiveness was assessed using pre-specified rules. MAIN RESULTS Twenty-two studies with a total of 2628 patients (age 12 to 78 years) met the inclusion criteria. Five types of headache were studied: migraine, tension-type, cervicogenic, a mix of migraine and tension-type, and post-traumatic headache. Ten studies had methodological quality scores of 50 or more (out of a possible 100 points), but many limitations were identified. We were unable to pool data because of study heterogeneity. For the prophylactic treatment of migraine headache, there is evidence that spinal manipulation may be an effective treatment option with a short-term effect similar to that of a commonly used, effective drug (amitriptyline). Other possible treatment options with weaker evidence of effectiveness are pulsating electromagnetic fields and a combination of transcutaneous electrical nerve stimulation [TENS] and electrical neurotransmitter modulation. For the prophylactic treatment of chronic tension-type headache, amitriptyline is more effective than spinal manipulation during treatment. However, spinal manipulation is superior in the short term after cessation of both treatments. Other possible treatment options with weaker evidence of effectiveness are therapeutic touch; cranial electrotherapy; a combination of TENS and electrical neurotransmitter modulation; and a regimen of auto-massage, TENS, and stretching. For episodic tension-type headache, there is evidence that adding spinal manipulation to massage is not effective. For the prophylactic treatment of cervicogenic headache, there is evidence that both neck exercise (low-intensity endurance training) and spinal manipulation are effective in the short and long term when compared to no treatment. There is also evidence that spinal manipulation is effective in the short term when compared to massage or placebo spinal manipulation, and weaker evidence when compared to spinal mobilization. There is weaker evidence that spinal mobilization is more effective in the short term than cold packs in the treatment of post-traumatic headache. REVIEWERS' CONCLUSIONS A few non-invasive physical treatments may be effective as prophylactic treatments for chronic/recurrent headaches. Based on trial results, these treatments appear to be associated with little risk of serious adverse effects. The clinical effectiveness and cost-effectiveness of non-invasive physical treatments require further research using scientifically rigorous methods. The heterogeneity of the studies included in this review means that the results of a few additional high-quality trials in the future could easily change the conclusions of our review.
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Affiliation(s)
- G Bronfort
- Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, 2501 W 84th St, Bloomington, MN 55431, USA.
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Vernon H, McDermaid CS, Hagino C. Systematic review of randomized clinical trials of complementary/alternative therapies in the treatment of tension-type and cervicogenic headache. Complement Ther Med 1999; 7:142-55. [PMID: 10581824 DOI: 10.1016/s0965-2299(99)80122-8] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To conduct a systematic review of the randomized controlled clinical trials (RCTs) of complementary/alternative (CAM) therapies in the treatment of non-migrainous headache (i.e. excluding migraine, cluster and organic headaches). DESIGN Systematic review with quality scoring and evidence tables. MAIN OUTCOME MEASURES Number of RCTs per therapy, quality scores, evidence tables. RESULTS Twenty-four RCTs were identified in the categories of acupuncture, spinal manipulation, electrotherapy, physiotherapy, homeopathy and other therapies. Headache categories included tension-type (under various names pre-1988), cervicogenic and post-traumatic. Quality scores for the RCT reports ranged from approximately 30 to 80 on a 100 point scale. CONCLUSION RCTs for CAM therapies of the treatment of non-migrainous headache exist in the literature and demonstrate that clinical experimental studies of these forms of headache can be conducted. Evidence from a sub-set of high quality studies indicates that some CAM therapies may be useful in the treatment of these common forms of headache.
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Affiliation(s)
- H Vernon
- Canadian Memorial Chiropractic College, Toronto, Canada
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Southworth S. A study of the effects of cranial electrical stimulation on attention and concentration. INTEGRATIVE PHYSIOLOGICAL AND BEHAVIORAL SCIENCE : THE OFFICIAL JOURNAL OF THE PAVLOVIAN SOCIETY 1999; 34:43-53. [PMID: 10381164 DOI: 10.1007/bf02688709] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There have been several anecdotal accounts that cranial electrical stimulation (CES) enhances attention and the ability to learn new tasks in a normal population, but only one published investigation confirms that CES improves attention using the Alpha Stim CES (Madden and Kirsch, 1987). The purpose of this study was to corroborate the findings of Madden and Kirsch, using more precise measures of attention, such as a Continuous Performance Test (CPT). A pretest and posttest CPT was given to two groups using the LISS CES device. The control group consisted of twenty-one subjects who received the placebo treatment. The experimental group of thirty-one subjects received twenty minutes of CES. Four measures of the CPT show significant gains in attention: Number of Hits, p =.010 Hit RT ISI Change, p =.016, Risk Taking, p =.055; and Attentiveness, p =.054. Based on subjects who demonstrated improvement by one standard deviation on two different measures of the CPT, thirty-one percent of the experimental group improved versus four percent of the control group. The use of CES as a method of increasing attention is a promising area that requires further investigation.
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Affiliation(s)
- S Southworth
- The Family Institute and Associates, Kansas City, MO 64114, USA
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DE FELICE EUGENEA. CRANIAL ELECTROTHERAPY STIMULATION (CES) IN THE TREATMENT OF ANXIETY AND OTHER STRESS-RELATED DISORDERS: A REVIEW OF CONTROLLED CLINICAL TRIALS. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/(sici)1099-1700(199701)13:1<31::aid-smi715>3.0.co;2-g] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Liss S, Liss B. Physiological and therapeutic effects of high frequency electrical pulses. INTEGRATIVE PHYSIOLOGICAL AND BEHAVIORAL SCIENCE : THE OFFICIAL JOURNAL OF THE PAVLOVIAN SOCIETY 1996; 31:88-95. [PMID: 8809593 DOI: 10.1007/bf02699781] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The results of stimulating human subjects with the LISS Cranial Stimulator (LCS) and the LISS Body Stimulator (LBS) include an increase or decrease in the activities of certain neurotransmitters and neurohormones and the reduction of associated pain, insomnia, depression, and spasticity. The effects were documented in human subjects with measurements of the serum concentration of the various agents and assessments of the symptoms being performed before and after stimulation. The stimulators had a carrier frequency of 15,000 hz, which utilizes the bulk capacitance of the body, and a 15 hz modulating bioactive frequency. The second modulating frequency presently used, 500 hz, reduces the energy input to the patient by half. Significant increases in levels of CSF serotonin and beta endorphin were recorded post stimulation. There were also elevations in the levels of plasma serotonin, beta endorphin, GABA and DHEA together with diminished levels of cortisol and tryptophan. Concomitant with these changes were significant improvements in the symptoms of pain, insomnia, spasticity, depression, and headache.
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Affiliation(s)
- S Liss
- MEDI Consultants, Inc., Paterson, New Jersey 07504, USA
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Gauthier JG, Ivers H, Carrier S. Nonpharmacological approaches in the management of recurrent headache disorders and their comparison and combination with pharmacotherapy. Clin Psychol Rev 1996. [DOI: 10.1016/0272-7358(96)00031-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
Acute tension-type headache is a very common condition that rarely is a problem in treatment. Chronic tension-type headache, however, is often a difficult therapeutic problem. The pathogenesis is not well understood, but both peripheral muscle contraction and central pain-modulating systems are probably involved. Therapy usually works best when multiple techniques are used, including pharmacologic, psychological, and physiologic modalities.
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Affiliation(s)
- R S Kunkel
- Department of Internal Medicine, Cleveland Clinic Foundation, Ohio
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